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Published: Monday, 3/15/2010

Suit alleges excessive delays of health care

BY ERICA BLAKE
BLADE STAFF WRITER
Victoria Bigelow, seeking disability designation, is among plaintiffs suing the Department of Job and Family Services. Victoria Bigelow, seeking disability designation, is among plaintiffs suing the Department of Job and Family Services.
THE BLADE/DAVE ZAPOTOSKY Enlarge | Buy This Photo

When Victoria Bigelow began the process of acquiring Medicaid benefits through the state of Ohio, she was having liver problems.

She required back therapy. She was unable to work because of pain.

Now, 18 months later and still waiting, she feels desperate, she said.

Advocates say Ms. Bigelow is one of thousands of Ohioans who have been denied timely health-care benefits.

Like Ms. Bigelow, applicants wait months and sometimes years, according to a lawsuit filed recently in U.S. District Court in Toledo.

"I don't want to miss anything in life because I can't get basic medical care," a tearful Ms. Bigelow said. She is worried her health will continue to deteriorate before she is able to enjoy her three grandchildren.

"It makes me so sad and so scared," she said.

Ms. Bigelow is one of five individuals who, along with the Ability Center of Greater Toledo, have filed suit against the Ohio Department of Job and Family Services.

The state agency is represented by the Ohio Attorney General's Office, which declined to comment. Kim Kowalski, a spokesman for the attorney general's office, said state attorneys typically do not discuss pending litigation.

The complaint alleges Ohio takes too long reviewing cases, causing many people to be shut out of Medicaid services for unreasonable lengths of time while waiting for decisions on their disability claims.

According to lawyers from Advocates for Basic Legal Equality Inc., or ABLE, the delays are excessive enough to violate federal mandates and put residents at risk.

The lawsuit asks Judge James Carr, the presiding jurist, to ensure that the state gets "in full compliance with every order of this court."

More than 15,000 applications from low-income residents are awaiting state approval.

Many are not likely to be processed within the federally allowed 90-day timetable, W. David Koeninger, ABLE attorney, said.

"In some cases, eligible low-income residents have waited for more than two years for such a determination," said Mr. Koeninger, who added, "The current system has holes."

The Ability Center of Greater Toledo has been collecting state statistics about the number of people waiting for - as well as denied - designations.

Ms. Bigelow, 47, of Toledo said she worked until August, 2008, at a factory.

But because she was employed through a temporary-staffing agency, she didn't have medical benefits. "When I worked, I paid for the best care I could on minimum wage," she said.

Diagnosed with Hepatitis C, spondylosis (a degenerative disease of the spinal discs), and depression, Ms. Bigelow said she is unable to walk without a cane. She worries about one day needing a liver transplant.

ABLE attorney Bob Cole said that Ms. Bigelow had been told to acquire additional information to have her disability status approved.

But without health care, she couldn't obtain the tests and she wasn't being told that help was available.

"There are states that have very little difficulty complying with federal law," Mr. Cole said. "This isn't a problem that can't be fixed. … You need adequate staff and adequate support at the county level."

Attorneys said counties throughout the state differ in their levels of support.

"It will be as quick as we can make it," Mr. Cole said of bringing the case through the courts.

"This is not an exercise in academics. There are people out there, their conditions are deteriorating and they need health care."

Ms. Bigelow said it's "such a shame to have so many people out there sick and maybe dying because they're waiting for health care."

Contact Erica Blake at:

eblake@theblade.com

or 419-213-2134.



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